Usefulness of the dipyridamole-Doppler test for diagnosis of coronary artery disease

Am J Cardiol. 1990 Apr 1;65(13):829-34. doi: 10.1016/0002-9149(90)91422-3.

Abstract

Two-dimensional and Doppler echocardiographic studies and a hemodynamic investigation were performed during dipyridamole testing in 42 subjects (13 control subjects and 29 patients with coronary artery disease [CAD]), to evaluate the ability of dipyridamole Doppler echocardiography in identifying patients with ischemic left ventricular dysfunction. In the control group, after dipyridamole infusion, Doppler-derived parameters increased significantly from baseline (p less than 0.001). In patients with CAD, peak flow velocity, flow velocity integral and stroke volume failed to increase after dipyridamole infusion (0.89 +/- 0.21 to 0.85 +/- 0.18 m/s, difference not significant; 14 +/- 3 to 12 +/- 4 cm, difference not significant, and 56 +/- 13 to 50 +/- 14 ml/beat, p less than 0.05, respectively). Heart rate, rate pressure product, systemic vascular resistance and mean right atrial pressure had similar variations in the 2 groups. Changes in the 3 Doppler-derived parameters are closely related to the variations of peak positive dP/dt, stroke volume (thermodilution) and left ventricular end-diastolic pressure and are closely related to the coronary angiography jeopardy score and to the appearance of wall motion abnormalities. Thus, by combining Doppler and 2-dimensional echocardiography, dipyridamole-induced myocardial ischemia may be detected in a high percentage of CAD patients, providing a sensitive tool for identifying patients with high-risk coronary artery anatomy.

MeSH terms

  • Adult
  • Aged
  • Coronary Angiography
  • Coronary Disease / diagnosis*
  • Coronary Disease / physiopathology
  • Dipyridamole*
  • Echocardiography
  • Echocardiography, Doppler*
  • Female
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Observer Variation

Substances

  • Dipyridamole